Table 3.
Proportion (percentage) of knee and hip replacement procedures carried out in safety net hospitals before and after health reform in Massachusetts
| Before reform (95% CI) | After reform | Mean % change in share in safety net hospitals after reform† (95% CI) | ||
|---|---|---|---|---|
| Observed | Mean expected* (95% CI) | |||
| All | 12.7 (12.2 to 13.3) | 12.1 | 13.1 (12.9 to 13.3) | −1.0 (−1.4 to −0.6) |
| Race/ethnicity: | ||||
| White, non-Hispanic | 11.5 (10.9 to 12.0) | 10.7 | 11.7 (11.4 to 11.9) | −1.0 (−1.4 to −0.6) |
| Black, non-Hispanic | 30.4 (26.9 to 33.9) | 28.3 | 29.5 (28.6 to 30.4) | −1.2 (−3.7 to 1.3) |
| Hispanic | 30.3 (25.0 to 35.7) | 22.0 | 28.4 (26.8 to 30.0) | −6.4 (−9.8 to −3.0) |
| Zip code median income: | ||||
| Low | 25.3 (23.7 to 26.9) | 22.8 | 26.7 (25.9 to 27.4) | −3.9 (−5.0 to −2.8) |
| Medium | 12.9 (11.9 to 14.0) | 11.6 | 12.8 (12.5 to 13.1) | −1.2 (−2.0 to −0.4) |
| High | 8.0 (7.4 to 8.6) | 8.1 | 8.1 (7.9 to 8.2) | 0.0 (−0.5 to 0.5) |
*Estimated from logistic regression model of receipt of procedure at safety net hospital with covariates of patient age, sex, Charlson comorbidity score, and difference in distance between residence zip code to nearest safety net hospital and to nearest non-safety-net hospital.
†Difference between observed and expected % share of knee and hip replacement procedures after reform in safety net hospitals.